Deep Granuloma Annulare (Pseudorheumatoid Nodule) in Children: Clinicopathologic Study of 35 Cases

Deep granuloma annulare (DGA) is one of several lesions of skin and superficial soft tissues whose histologic character is a palisading granuloma with a small central focus of necrosis or necrobiosis. Unlike the other palisading necrobiotic lesions, DGA has a predilection for children in the first 5 to 6 years of life. A painless subcutaneous nodule(s) in the lower anterior tibial region or foot and the scalp, typically in the occiput, was the most common presenting feature in this study of 35 cases. Additional or recurrent lesions were reported in approximately 70% of cases with clinical follow-up. All lesions showed the presence of necrobiosis; however, one of the characteristic features was the multinodular character of the predominantly mononuclear cellular aggregates. The presence of vascular spaces at the periphery of the nodular profiles served as a clue to the diagnosis of DGA. The palisading arrangement of the mononuclear cells was evident only in those foci with central necrobiosis. A histiocytic disorder or fibrohistiocytic process was a common consideration in the differential diagnosis, especially in those cases with less apparent foci of necrosis. Palisading histiocytes with prominent eosinophilic cytoplasm and some nuclear atypism were problematic with regard to possible epithelioid sarcoma. Our study failed to identify any underlying or predisposing factors in the development of DGA. Despite the fact that DGA is a well-documented lesion in children, it occurs sufficiently infrequently that it is often not considered clinically when it presents as a subcutaneous mass or masses in a child. Its recognition by the pathologist is especially important as the occurrence of additional lesions in a high proportion of children can be anticipated without undue concern. Received June 16, 1997; accepted October 28, 1997.     

Immunization-induced inflammatory infiltration of the central nervous system in transgenic mice expressing a microbial antigen in astrocytes

Transgenic mice expressing a defined microbial antigen from central nervous system (CNS) cell type-specific promoters can be utilized to investigate the consequences of induction of peripheral immune responses to foreign antigens produced by different CNS cell types. Immunization of mice expressing β-galactosidase (β-gal) in astrocytes with this protein resulted in antigen-dependent infiltration of the CNS by mononuclear cells, principally CD4⁺ T lymphocytes and monocyte/macrophages. The perivascular and intraparenchymal infiltrates, which were located predominantly in the hippocampal formation and cerebellum, the areas of highest β-gal expression, were associated with astrocytosis, microgliosis, and a generalized increase in blood-brain barrier permeability. The resemblance of these pathological changes to aspects of human immune inflammatory CNS disorders e.g. multiple sclerosis, suggests that an initiating step in the process by which such complex diseases are produced could be the induction of peripheral immune responses to antigens expressed in astrocytes.     

含化复方新诺明引起过敏性休克一例

含化复方新诺明引起过敏性休克一例患者，女，３０岁，因咽峡炎于１９９２年８月７日晚１０时自行含化复方新诺明（广州白云山制药厂）两片、约７分钟后，出现全身搔痒，当即肌注苯海拉明２０ｍｇ，静推１０％葡萄糖酸钙１０ｍｌ，旋即全身泛起荨麻疹，奇痒难忍，眼睑轻度水肿，嘴唇发麻，咽部“发紧”，发音困难，烦躁，立即给予吸氧，静推地塞米松１０ｍｇ，皮下注射肾上腺素０．５ｍｇ，与此同时，患者脸色苍白、鼻尖、未梢发凉，口唇紫绀，时吸暂停，意识丧失，脉搏１４０次／分，细数，血压测不到，再次给予皮下注射肾上腺素０．５ｍｇ，静点地塞米松１５ｍｇ，并给予扩容、纠酸，约一分钟后，欲行气管切开时，患者呼吸渐恢复、继而意识清楚，紫绀减轻，血压１０／１６ｋＰａ，遂休克纠正。复方新诺明片致过敏性休克者尚属少见，该患者有青霉素过敏史，局部用药又易致过敏，考虑喉头痉挛与药物含化有关。（长治市人民医院王爱军，崔文华，郭天然）含化复方新诺明引起过敏性休克一例@王爱军，崔文华，郭天然$长治市人民医院     

Relationship of "bleeding on probing" and "gingival index bleeding" as clinical parameters of gingival inflammation

Abstract Bleeding on probing (BOP) and the gingival index have been used to clinically characterize the degree of gingival inflammation. It is, however, unclear to what extent these parameters correlate to each other and to probing pocket depth (PD). The purpose of this clinical study was to evaluate the association between BOP and GI bleeding (scores of 2 and 3), as well as the relationship of these variables to PD, in a group of patients presenting with naturally-occurring gingivitis. Based on screening examinations of 125 subjects with at least 20 teeth, no more than 4 sites with PD over 6 mm, a BOP frequency of 30% or greater, and no systemic condition that would influence the inflammatory response, were selected. 2 weeks after screening they were examined at 6 sites per tooth for plaque index, GI, PD and BOP. A standardized pressure sensitive probe (Florida Probe) with 20 g probing force was used for BOP and PD measurements. In this population, means of 40.9% (S.E.= 1.36) BOP sites and 35.3% (S.E, = 1.81) GI bleeding sites per patient were found. A total of 20,008 sites ranging in PD up to 5.9 mm were evaluated; however, the majority of sites (19,723, 98.6%) presented with <4 mm PD. When sites were evaluated, BOP demonstrated a positive correlation with PD, whereas GI bleeding correlated with PH. For sites characterized by the absence of BOP as well as the absence of GI bleeding (scores 0 and 1), the highest % of agreement between the 2 indices (77.7%) was found in shallow sites (0.1–2 mm). In contrast, when sites presenting with both BOP and GI bleeding were analyzed, the highest % of agreement (85,4%) was found for sites with PD >4.0 mm. In this gingivitis population group, it appears that BOP and GI bleeding evaluate distinct inflammatory1 conditions of the gingival tissues, and the relationship between the 2 clinical parameters may vary according to PD at the individual site examined.     

Inhibition of rat heart allograft rejection by a PUVA treatment of the graft recipient

Treatment of rat heart grafts with PUVA, the combination of the photosensitizer 8-methoxypsoralen and longwave ultraviolet light, leads to a prolonged transplant survival in allogeneic recipients. A PUVA treatment of the recipient rats, performed for 7 consecutive days after transplantation, prolonged graft survival even more effectively. This may be due to the systemic immunomodulatory effects of PUVA in the recipient. One of the mediators is urocanic acid, which is transformed by ultraviolet light in the skin from its trans- to the cis-isomer, which, in turn, acts as a mediator on the immune system. An injection of cisurocanic acid into graft recipients for 7 consecutive days after transplantation resulted in prolonged graft survival; in 40% of the rats, permanent graft acceptance was observed. The significance of these results for clinical organ transplantation is discussed.     

Flow cytometry analysis of platelet antibodies

We have devised assays to detect both circulating alloantibodies to platelets (indirect assay) and platelet-association IgG and IgM (direct assay) using a flow cytometric technique. A variety of patients with immune thrombocytopenia were studied. Employment of a confocal lens in the flow cytometer increased the discrimination power of the instrument. Patients with autoimmune thrombocytopenia (idiopathic thrombocytic purpura [ITP], systemic lupus erythematosus (SLE), lymphoma, leukemia, and drug-induced thrombocytopenia showed a significant increase in platelet-associated antibody. Circulating antibodies to platelets (alloantibodies) were demonstrated in cases of platelet refractoriness and neonatal isoimmune purpura. Day-today precision of the assays ranged from 3% to 6% (coefficient of variation). No interference was shown in the presence of hemoglobin (5 g/L), triglycerides (10 g/L), or polyclonal and monoclonal immunoglobulinemia (50 g/L: IgG, IgA, IgM). The sensitivity of the direct assay was 500 attograms of IgG or IgM platelet.     

方格星虫提取物对雄性小鼠免疫及生殖器官的辐射防护作用

目的 观察方格星虫提取物对y射线损伤雄性小鼠免疫器官及生殖器官的保护作用.方法 将50只雄性小鼠随机分为正常对照组、模型组及低[0.5g/(kg·d)]、中[1.0g/(kg·d)]、高[2.0g/(kg·d)]3个剂量方格星虫提取物组,每天灌胃给药1次,给药剂量为2.0 mL/kg,灌胃2周后,除正常对照组外,各组均以剂量率为0.83 Gy/h的60Co γ射线进行1次全身照射,照射剂量为5 Gy.于辐照前1 d,辐照后第3天、第14天测定小鼠体重、外周血白细胞数,辐照后第14天测定小鼠胸腺指数、脾指数、骨髓有核细胞计数、睾丸重量指数、精子总数及精子畸形率.结果 方格星虫提取物可使辐照后第3天3个剂量组小鼠外周血白细胞数明显高于模型组(P＜0.05),辐照后第14天3个剂量组小鼠的胸腺指数及脾指数明显高于模型组(P＜0.05),低、中剂量组小鼠的骨髓有核细胞数显著高于模型组(P＜0.05),高剂量组小鼠骨髓有核细胞数显著高于模型组(P＜0.01),中、高剂量组睾丸重量指数、精子总数明显高于模型组(P＜0.05),中、高剂量组的精子畸形率显著低于模型组(P＜0.01).结论 方格星虫提取物对辐射损伤小鼠的免疫器官及生殖器官具有一定的保护作用.     

姬松茸多糖的抗炎作用

[目的 ]观察姬松茸多糖的抗炎作用 .[方法 ]制作二甲苯所致小鼠耳急性炎症模型、角叉菜胶所致大鼠关节肿胀模型、小鼠棉球肉芽肿亚急性炎症模型和大鼠佐剂关节炎模型 ,给予 4 0 ,80 ,16 0mg/kg的姬松茸多糖 .[结果 ]姬松茸多糖明显抑制上述各类型炎症反应 .[结论 ]姬松茸多糖具有抗炎作用 .     

Elevation of cell adhesion molecule immunoreactivity in the anterior cingulate cortex in bipolar disorder.

BACKGROUND: Neuroimaging reports of increases in signal hyperintensities in white and deep gray matter and other work indicate that there might be an inflammatory response in affective disorders. METHODS: The microvascular immunoreactivity of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 was measured with image analysis in postmortem tissue from the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (DLPFC) from 15 unipolar and 15 bipolar subjects and compared with each other and with 15 subjects with schizophrenia and 15 control subjects. RESULTS: Intercellular adhesion molecule-1 immunoreactivity in gray and white matter of the ACC in bipolar subjects was increased compared with control subjects (gray: p =.001; white: p <.001) and schizophrenic subjects (gray: p =.016; white: p =.025) and modestly increased in white matter compared with unipolar subjects (p =.049). No such differences were found in the DLPFC. CONCLUSIONS: These findings are consistent with the presence of an inflammatory response in the ACC in bipolar disorder.     

亮菌多糖抗小鼠辐射损伤作用的研究

目的观察亮菌多糖（ATS）对辐射损伤的保护作用。方法将小鼠随机分为空白对照组（0．9％生理盐水）、辐射模型组、阳性对照组（参芪片）和ATS多糖不同剂量实验组（80、160和320mg／kg）。以γ射线照射小鼠全身，引起辐射损伤后观察各组小鼠30d存活率、白细胞（WBC）数、精子畸变率、骨髓微核（MN）细胞数、骨髓DNA含量和免疫器官重量及血清和肝组织中的超氧化物歧化酶（SOD）和丙二醛（MDA）含量等。结果ATS能提高受照小鼠存活率（P〈0．05）及SOD活性（P〈0．05）、升高WBC数（P〈0．05）和骨髓DNA含量（P〈0．05），抑制小鼠精子畸变率（P〈0．05）和骨髓MN细胞数的增加（P〈0．05），并使受照小鼠胸腺、脾脏重量回升（P〈0．05），还能增加内源性脾结节数（P〈0．05），降低MDA含量。结论ATS对γ射线所致小鼠辐射损伤有较好的保护作用。